An eczema elimination diet really isn’t as hard as it may seem and for many, it provides a great sense of relief when food allergies or intolerances are discovered. In truth, it’s deciding to do the elimination diet for atopic dermatitis and embracing your decision by fully planning and preparing for it, that’s the hardest. But it’s worth it! This is what I feel is truly the best type of “eczema diet” for everyone and is one I strongly recommend everyone tries in order to discover their own unique food triggers that may be causing eczema to flare.
Why an Elimination Diet for Eczema?
After years of worsening eczema and unsuccessful attempts with multiple doctors to identify the triggers, I finally realized I could no longer put off an eczema elimination diet for my son. It was time to figure out which foods were aggravating his eczema when allergy testing all came back negative. The best way to do that, according to many health professionals, in fact it’s considered the “gold standard” for food allergy diagnosis by many pediatricians, is by conducting a food challenge. A food challenge is when certain foods are consumed in small doses and then the individual is monitored very closely, in a physicians office is best, to determine if the food causes any reaction in the body.
Food challenges are the only 100% accurate way to prove a food allergy exists, other than a history of reactions to specific foods. Food allergy testing, including a skin prick test or a blood test, is not usually reliable as false positives and false negatives, like was the case with my son, can frequently occur.
A variation of this you can do at home, under a physician’s supervision, is the elimination diet for eczema. The way it works is through eliminating foods from your diet for a specific period of time, usually at least around one month, then you add them back in slowly over time to determine which foods are causing a reaction. While certain foods, like the top food allergens, are often to blame, not all of them offend everyone’s skin and sometimes there are food triggers outside of the common food allergies that must later be identified. But I call an elimination diet the ultimate “eczema diet” as it can uncover your own unique food triggers of allergic reactions and help you find better skin and better health.
One important thing to note about undergoing an eczema elimination diet is it is NOT a long–term diet. The idea with an elimination diet for eczema is that it can help you to identify your food triggers so you can reduce your intake of that food, but not remove the food altogether. Removing the food altogether may cause more harm than good – lack of nutrients and possibly increasing your sensitivity to the food and in some cases maybe even developing a full–blown allergy to the food, which we think MAY have happened to my son with dairy, but there is no way to prove it.
So, once a food is identified as a trigger, the best thing to do is to speak with your physician and nutritionist to work out a plan on how to incorporate the food back into your diet on a rotational basis. In general, consuming a food that triggers eczema or other mild reactions, only once every four days is a good rule of thumb to allow the body a chance to heal in between and for the food not to build up in your system.
So, don’t worry. Even if gluten or dairy or another of your favorite food is identified as a trigger, it doesn’t mean you can NEVER EVER have that food again.
Now, let’s dig into the details.
Overwhelmed? Embrace the Eczema Elimination Diet and Plan, Plan, Plan
When I finally decided to move forward with my son’s elimination diet for eczema, the planning seemed very overwhelming. It’s best to work with a physician or nutritionist when planning the eczema elimination diet to ensure all the proper foods are eliminated correctly AND to guarantee you’re not putting your or your child’s health in jeopardy. Removing nutritious foods from the diet means they need to be substituted with equally nutritious alternatives and this can be tricky if you’re not very well versed in a healthy eating and nutrition.
Not only is balancing nutrition hard, but it’s VERY difficult to remove staple foods from your diet. Many of the foods that should be eliminated have been in your or your child’s diet since not long after you took your first bites of food as a baby. Perhaps, your body has been used to these foods for so long, that slowly over time a reaction has been building up and taking form as eczema or asthma. You don’t always consciously think about these foods because they’re part of you. You’ve never had to think about it before. So eliminating these foods is like learning a whole new language. You must become a thorough label reader, understand the confusing and misleading world of “may contain traces of,” recognize alternative names for foods (and there are many), and learn to cook with substitute ingredients.
Find the Right Resources
Luckily, my mother-in-law is a super health food fanatic, so I relied much on her expertise when it was time to start our elimination diet for eczema. I also referenced Dealing with Food Allergies in Babies and Children. This is an EXCELLENT book that discusses food allergies in-depth and then offers detailed steps on how to conduct elimination diets for various ailments – one of which is eczema! Using Dr. Vickerstaff Joneja’s plan, made things much easier. Her book told me exactly what to eliminate and for how long. We followed her eczema elimination diet to the letter and it improved my son’s skin tremendously, within a matter of days. When it was time to add the eliminated foods back into his diet, by way of a food challenge, we immediately were able to identify which foods were triggering his eczema symptoms as he became very itchy after eating most of them, occasionally with hives. In some cases it took a few days of consuming the foods to see a reaction. In the end we identified the following as eczema triggers for my son: dairy, gluten, soy, and corn. We later also identified through trial and error that many tree nuts cause similar reactions for him.
I’m happy to say that through an elimination diet, we saw major improvements in my son’s skin! This was one of the biggest wins in his battle against eczema. I cannot recommend elimination diets enough.
[Update 2/17/2015: Another book I now recommend that covers elimination diets and goes into much more detail about healing eczema from within is The Eczema Cure. I know the title is a tad too promising (I’m not a fan of the word “cure”) but it really is full of great information and I found this ebook incredibly helpful.]
[Update 1/19/2017: We finally decided to try Auto Immune Paleo and found that it removed the last small, lingering bit of my son’s eczema. Read more about our journey Our Eczema Trials: Auto Immune Paleo and Eczema.]
[Update 5/3/2018: I have recently read and loved Prime Physique Nutrition’s The Elimination Diet: A Complete Guide to Conquer Eczema & Food Sensitivities eBook. It covers why an elimination diet is a good idea for those suffering with eczema along with what to eliminate and for how long. The book also has some sample recipes to get you started and suggestions on how to reintroduce foods and track skin reactions. This is a GREAT guide for anyone wanting to find which foods are triggering their eczema.]
Yes, elimination diets are hard, but you CAN do it. Here’s how:
- Embrace the decision 100%.
- Arm yourself with the right resources: physician, nutritionist, books, friends for moral support, etc.
- Have recipes ready to go and your pantry stocked. Plan on spending a few hours at the grocery store carefully reading labels and finding new food substitutes. TIP: I use RealPlans to help me plan out my meals for the entire week. What I love most is that it lets me filter recipes by ingredients and I can set known allergies and foods I’ve eliminated. And in the end it provides me with a shopping list – only one trip to the store each week – LOVE THAT!
- Go for it! If you feel the need to cheat, think about why you want to cheat. Is it because you’re craving one of your favorite boxed/processed chocolate chip cookies that are no longer ok to eat every day? Then make some using alternative ingredients. Trust me, the alternatives are actually really good!
- If you’re nursing, check out this post about an tips for a breastfeeding elimination diet.
- Once you identify your food triggers, eat them only once every four days or as recommended by your physician. And learn ALL the alternative names for these foods.
Elimination Diet (Eczema) – Frequently Asked Questions
Is an elimination diet worth it?
As I have already mentioned, trying an elimination diet is definitely worth it. Food allergy testing, no matter which type of test you do, is not always accurate, and you might end up with a positive test for something that actually doesn’t cause your atopic dermatitis to act up and your eczema symptoms to appear. An elimination diet is one of the most accurate ways of determining food sensitives and allergies.
What are the most common food allergens?
When it comes to eczema and food allergies, there are plenty of foods that can trigger them. However, certain foods trigger eczema symptoms more often than others. Those are dairy, eggs, tomatoes, citrus fruits (particularly oranges and orange products), peanuts and other nuts, soy, wheat, gluten, and sugar.
What are the risks of an elimination diet?
The most common risk of an elimination diet for atopic dermatitis is malnutrition. The elimination diet can end up doing more harm than good if you’re doing it on your own, without the supervision of a nutritionist or someone else who knows the ins and outs of healthy eating and how to substitute the foods that had to be eliminated.